Suggest Your Health Resource

* = Required field
NOTE: This form will NOT automaticaly add your resource to our website. It will be reviewed by a member of the staff before submission.

Site Location

*Name:

Enter the name of your service provider

Organization:

If you have a parent organization, enter that here

Office Location Name:

If your service has multiple locations, enter the specific name of the office being listed (eg, Northeast Office)

*Address:

Street name, suite number, etc. Information that tells where you are located.)Note: If your service does not have a physical presence for clients, but is Web-based or Phone-based, indicate that in your description and do not complete the address-related fields (Address, City, State, Zip).

*City:

Name of town, city, or community where service is located

*State:

Use 2-letter postal abbreviation (SC)

*Zip:

5-digit Zip code

*Phone:

Enter phone numbers clients use; if you have multiple numbers, enter those with an explanation (Toll-free, For appointments, etc.)

Public Email:

Public e-mail address for client use

*Contact Email:

E-mail address for us to contact you

Web Address (URL):

Address of your service's Web site

Fax:

*Description:

Briefly describe your services to explain the kinds of disease/conditions you treat and services you offer. Include any accommodations you make for the uninsured or Medicaid patients. Marketing language will be edited out.

*Counties or Regions Servicing:

Check your county of location and each county within your service area

Abbeville

Aiken

Allendale

Anderson

Bamberg

Barnwell

Beaufort

Berkeley

Calhoun

Charleston

Cherokee

Chester

Chesterfield

Clarendon

Colleton

Darlington

Dillon

Dorchester

Edgefield

Fairfield

Florence

Georgetown

Greenville

Greenwood

Hampton

Horry

Jasper

Kershaw

Lancaster

Laurens

Lee

Lexington

Marion

Marlboro

McCormick

Newberry

Oconee

Orangeburg

Pickens

Richland

Saluda

Spartanburg

Sumter

Union

Williamsburg

York

Statewide

The following sections of the application help us assign your service to the appropriate search terms so it will show up in the correct places in the Go local Directory. The Local Service Terms and health Topics are used together and in combination with the county assignments to determine when your service will appear in a search results list.